STEVE LEVINE
PUBLIC HEALTH
“Obesity is a disease” AMA declaration may influence insurers
BY CRYSTAL ZUZEK The American Medical Asso- ciation House of Delegates’ vote in June to classify obesity as a “disease state with multiple pathophysi- ological aspects requiring a range of interventions to advance obesity treatment and prevention” sparked national debate. Critics worry calling obesity a disease will take focus off prevention and remove personal responsibility from the equation. Sup- porters say the classifica- tion is bound to spur inno- vative policy, research, and treatment approaches to obesity. Physicians by and large hope that the new label will persuade private health plans and Medic- aid to pay for treatment of obese patients. At TexMed 2013, the
Texas Medical Association House of Delegates ap- proved a resolution intro- duced by the Travis County Medical Society strongly advocating that insurance plans “in- clude obesity as a covered outpatient medical condition.” TMA took the resolution to the AMA Annual Meeting and, upon realizing the momentum of support for the American Associa- tion of Clinical Endocrinologists’ (AACE’s) resolution calling for the recognition of obesity as a disease, TMA cosponsored AACE’s resolution.
Dallas endocrinologist Jonathan Leffert, MD, secretary of
AACE and an AMA alternate delegate, was instrumental in achieving passage of the resolution. “The scientific evidence is overwhelming,” he told fellow delegates. “Obesity is a disease.”
Dallas endocrinologist Jonathan Leffert, MD, helped persuade the American Medical Association House of Delegates to adopt a policy that classifies obesity as a disease at the AMA Annual Meeting in June.
“Obesity has become dis- tinguished as a multihor- monal, multidimensional, pathophysiological process with effects on the body. By treating obesity we can obviate those effects,” he said. “Obesity is a multi- factorial issue that goes be- yond lifestyle choices, and the AACE felt it should be classified as a disease.” Before the meeting, the AMA Council on Science and Public Health issued a 14-page report (http://
bit.ly/11Xh4Ip) titled “Is Obesity a Disease?” Dur- ing the meeting, Coun- cil Chair Russell Kridel, MD, of Houston, told Texas Medicine the council stopped short of answering yes to that question due to the uncertain definitions of “obesity” and “disease,” coupled with the inability to link a high body mass index (BMI) to consistent morbidity. He said the council could not conclude
that obesity is a disease “in the classic, commonly accepted way of looking at a disease.” Dr. Kridel said his council worried proclaiming obesity a disease might dissuade some people from eating right or exer- cising more to stay healthy or lose weight. “We don’t want people to think now that obesity is a dis- ease, we’re just going to treat it with medicine or surgery,” he said. “If we call it a disease, we don’t want to remove personal responsibility.” The AMA house adopted the council’s report and a new policy to classify obesity as a disease.
January 2014 TEXAS MEDICINE 45
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